Spotlight on Caring & Repairing

Break-in Britain Series 2 - The Crackdown

So in the middle of January 2015, Tony and I (Lyndon) were invited into Kelly Jones’s office. We were informed that we had volunteered for a special assignment involving the normal day to day work we carry out, but this time with the cameras of the BBC recording our every move!

We of course were naturally overjoyed to be the focal point of such attention, whilst showcasing the burgeoning talents of Swansea Care & Repair and Care & Repair services to the full. So after a discussion on materials and likely job types, and the possibility of one or two other members of staff joining in the fun, and the likelihood of “short notice” warnings of filming, we vacated Kelly’s office and returned to our duties.

A week or so later, the call came from upstairs that Tony and I were to report to a property in the Baglan area to install some security equipment as yet undecided. The BBC film crew would meet us there later. We duly arrived at the property of Dennis and Ann, and discovered the need to install new lockable window handles, patio door locks and the like for Tony, and a couple of security lights and a burglar alarm for me. We immediately set about our respective tasks and the BBC film crew along with the presenter Dan Donnelly soon arrived. They then proceeded to enquire about our work by asking us (individually) to explain to the camera what we were doing, and how the expected completion of our tasks would benefit the householders concerned. This we had to deliver several times as the “mike” was not working, or the wind was too “noisy”, or someone fudged his lines (Dan). They then proceeded to film us actually installing various items, and Dan the presenter even lent a hand (honest). Everything proceeded as planned; all electrical items were tested and certificated as required. Although fitting the burglar alarm sounder box on the outside wall of the property did prove problematic for me on the ladder and the BBC cameraman filming, while the snow was falling! Burglar alarm programmed and tested (with Tony’s assistance), we vacated the property, leaving the householders Dennis and Ann feeling safe in their home once more.

Two weeks later, the second week of February 2015, Tony and I were despatched to the Mumbles area to help Jackie, a single mother who works for the Prison service, after she had been burgled. To this end we installed a wireless alarm system, a security light at the rear and Tony fitted a new lock and some “sash jammers” etc. We were then joined by several more members of Care & Repair when David and Steve and even Raymond turned up to help fit a fence and gate at the rear of the property (this can be seen in the title sequence of the broadcast programmes where I am passing a fence panel to Dan, while Steve holds a drill, and Dave looks busy). In the first episode of programmes in series 2, all members of the Care & Repair team in attendance at the property ended up being shown on TV! Also at this address, we were pleased to encounter an ex-Care & Repair member Lloyd Thomas installing a new UPVC door and window assembly to the rear porch as part of the upgraded security measures for the property. As can be seen on the programme, Jackie says she will now be able to sleep at night knowing that her safety rating is much higher than before.

All in all it was really satisfying to help out in the above situations and, perhaps as it's being televised, it might raise the profile of Care & Repair and show the general public we really are there to help with their comfort, safety, and security.

Kelly Jones, Chief Officer
Swansea Care & Repair

Older people deserve better

The word 'deserve' disturbs me and implies that whoever ‘deserves’ has had to have done something to earn whatever is on offer. This actually implies an inequality for some people. Those people might be you, me, your sister, brother, mother or father. I have always been interested in how the use of language to describe people and practices does tend to influence attitude.

So I want to concentrate on the fact that we need to remove that word 'Deserve' and focus on rights for all people, recognising the humanity in us all.

It is amazing and indeed shameful that older people felt the urgent need in Wales to actually produce an explanation of what Human Rights meant to them.

But we must understand why we still have to use the word ‘Deserve’ when we consider older people's care and support. I think this is because there is still evidence out there of failed care, omissions of services and public inquiries into abuse.

My contention is that we are continually being pushed into lobbying for better services for older people, and using terms such as ‘Deserve’ indicates that society and public services still do not understand ageing or adequately recognise the real cost and benefit to supporting older people to maintain their health and wellbeing.

Similarly prejudicial remarks have long been recognised as inappropriate when applied to, for example, gender or ethnicity. So it seems that older people are still the last frontier and we are still having to use this term to get what older people actually need to enable them to experience a higher quality later life.

The attitudes that fester the lobbying for better services I have just mentioned affect assessments of need and packages of support. The customary diagnostic rigour which, for instance, healthcare professionals have been trained to apply as standard, can sometimes be mysteriously replaced for older people as patients by ageist therapeutic emptiness. In other words, nothing substantial to help them maintain their health. Professional values and training still overly prioritise the acute, the rare, the high-tech and the cure, and need to change to reflect the reality of modern health and social care practice which now is beginning to embrace, in partnership, the work undertaken within housing services for older people.

If we are providing a public service based on need and preventing ill health, and also implementing action on health and wellbeing as equally important, then we must give adequate and full assessments to all the people who actually turn up in the system, rather than for those whom we would find more personally engaging, or those ‘consumers’ who shout loudest.

It's great that the housing sector is championing a change in the approach to support for the older person and I am proud to be a part of that. However, there needs to be much more commitment all through the health system and action undertaken now which recognises the work that we, the housing champions for older people, have done to promote the rights of older people to continue to live independently and to experience a good later life.

Lets get to a situation in Wales where we never have to use the term ‘Deserve’ any more.

Lorraine Morgan
Board Member, Care & Repair Cymru

Security and older people

Thankfully, crimes against older and vulnerable people are relatively uncommon. However, when they do occur they can be very upsetting.

As providers of the only security rated key safe in the UK, we are often invited to provide guidance on general household security for elderly and vulnerable people. Key safes provide an easy and secure way of allowing authorised visitors to access your home. They significantly improve security compared to alternatives such as hiding a spare key under the mat, plant pot or in the garden shed and are commonly used by carers, GPs, family members and the emergency services.

There are very simple measures you can take to improve security. Whether you are 25 or 85, the advice for protecting yourself and your home is very similar.

Your first concern should always be your own personal safety. No matter if you are inside or outside your home, you should always make sure you have a means of contacting someone in the event of an emergency.

Today there are various ways to stay connected. Mobile phones are a great way to ensure that you can call for help in an emergency. With such a wide variety available, they can be as complex or as simple as you like. When you are inside your home, personal alarms or telecare devices allow you to alert family members, loved ones or a monitoring centre at the press of a button.

Protecting your home and valuables can be really simple and cost effective. Every once in a while, you should take a look at the various access points of your house and determine if they’re secure enough. It may be necessary to purchase additional locks for windows and doors or install door viewers and chains for extra security and peace of mind.

If you are unable to inspect or install additional security, don’t be afraid to ask for help from friends, relatives or neighbours. Most people out there are more than willing to help, especially when it comes to your security. Alternately, there are charities and organisations, like Care & Repair, who actively work to ensure that older people stay safe and secure in their own homes. It may also be possible to get help to pay for locks and chains.

Valuables should always be kept safe and not put on display. Keep your money in the bank, building society or post office and avoid keeping large sums of cash in the house. Today, most shops and retailers are equipped to deal with debit or credit cards. There is little need to carry large sums of cash to purchase goods or services. However, these changes in payment methods carry their own cautions. Remember to guard your card information and never keep your PIN number with your card. If you need any assistance or advice, your bank should be able to talk you through their own card security advice.

Remember, even the best security equipment is useless unless it is used. Be sure to always lock up properly, even if you are just popping out for a few minutes. You should always ensure that the access to your home is protected. When possible, avoid opening the door without a door chain and always check credentials of unscheduled visitors.

If you do have regularly scheduled visitors, ensure that you are familiar with their schedule and manage their access. You should always ensure that you remain in control of your home. You can do this by remembering to always lock your doors and windows and limiting the number of spare keys available. Preferably, you should always avoid handing out spare keys or leaving them exposed and unsecure. Burglars know that people tend to leave a spare key in a handful of places near their door and will often search these before attempting a break-in. Don’t make their job easier for them by leaving keys where they can easily be accessed. If you must leave a key outside, use a Police approved key safe and only give the code to people you trust.

Following this simple advice, combined with that of your local community Police, you should maintain a secure lifestyle.


Richard Conyers
Digital Executive
The Key Safe Company

www.keysafe.co.uk
@KeySafeUK
facebook.com/keysafeuk

Stronger Together – can cross-sector organisations work together to deliver successful solutions?

There are many stereotypes about the voluntary sector and also the commercial sector. The voluntary sector can be perceived to be a bit ‘hippy dippy’, extremely caring, but maybe not overly business-like, driven or innovative in approach; whereas the commercial sector are all pin-striped suit wearing salesmen who are all in it for the money. Obviously, these are extreme viewpoints for the purpose of this article and very few will believe that these are truly reflective, if at all. However, it can still be unusual for the two to work together, let alone work together to develop innovative and workable partnerships that deliver fantastic outcomes for all of those involved. The great news is that these partnerships are happening and are beginning to deliver real solutions to the challenges being faced in this new climate.

The history of Care & Repair in Wales began in the late 1970s. Concern about the circumstances of older people led to the early research about housing for older people. Successive studies and house conditions across the UK pointed to older people occupying disproportionately poor housing. Home Improvement Agencies (Care & Repair) developed in the UK in response to the growing awareness of problems faced by older homeowners living in housing that was statutorily unfit for habitation, lacking basic bathroom and kitchen amenities, damp, in serious disrepair, unhealthy and sometimes dangerous.

Fast forward to today and Care & Repair Cymru is now the ‘Older People’s Housing Champion’, supporting older people through not only housing repairs, but also many other valuable services such as benefits advice, housing adaptations, falls prevention, energy efficiency and affordable warmth. In 2013-14 alone the Care & Repair movement in Wales helped over 40,000 people through various interventions, helping older people to live in homes that enhance their quality of life.

In addition to on-the-ground support and individual help, Care & Repair Cymru also works to influence national policy and thinking; for example, appearing before Welsh Government Committees and UK Government Inquiries and advising on housing’s contribution to social care challenges, championing older people from grass roots to the very highest level.

Care & Repair Cymru has long recognised that to truly meet the needs of the older people they support, they need to look outside of traditional funding solutions and cannot rely on public sector funding alone. As with many third sector organisations, this has become particularly relevant in recent years following the credit crunch as budgets have been contracted with numbers of individuals needing vital services ever growing.

What has been particularly important to Care & Repair Cymru is that their Caseworkers are empowered to be able to help those that they look after in as many ways as possible. The last thing that a Caseworker or Care & Repair Cymru would ever want would be to be approached by an older person in need and not be able to help in any way. As part of increasing the number of options that Caseworkers have available to them, Care & Repair Cymru has made innovative partnerships with a number of organisations that can help them offer more options to those that they look after. One of these partnerships has been with social enterprise advant~age.

advant~age is a national organisation that enables charities to help vulnerable people, their families and carers, and supporters obtain access to safe and reputable products and services, whilst at the same time generating valuable unrestricted income for the charity and minimising reputational risk. One of the services that advant~age offers through its partner Bower Retirement Services is equity release advice. The role of advant~age includes performing rigorous due diligence and quality control on the providers of the services that it offers. This then ensures that customers can then be confident they will receive a high quality service at a fair price and charities can feel confident in signposting to providers, knowing that their reputations are protected. This was of particular importance to Care & Repair Cymru. With grants for repairs and adaptations shrinking, equity release advice can be an option that older people may want to consider as a way of funding works on their homes. As a member of the Equity Release Council and registered with the Financial Conduct Authority, Bower Retirement Services can offer safe and reputable, independent whole of market advice to individuals that may want to find out more about the options that are available to them.

Equity release isn’t the answer to everything, but by being able to signpost to reputable advice Care & Repair Cymru can increase the number of options that are available to those that they look after. For individuals that can mean access to funding to repair their homes and enable them to live more independently for longer, for Caseworkers it means that they can offer more solutions to more people more of the time. In addition to increasing the services available for any equity release services that are completed, a donation is made to the Care & Repair Cymru hardship fund, at no extra cost to the individual, enabling Care & Repair Cymru to deliver even more vital services in the communities it supports.

Care & Repair Cymru, advant~age and Bower Retirement Services believe that this type of cross-sector partnership will have a key role in the future provision of services to older people where traditional options are reducing or even disappearing. It is fantastic to see such a variety of organisations working together to develop and build services in partnership to provide solutions to the challenges that are being faced by individuals, third and public sectors alike.

For further information, please click here. 

Heather Dungey, Care & Repair Cymru
Jenni Buckland, advant-age
Ian Howarth, Bower

Who takes care of the carer?

A few years ago, my Dad was suffering with heartburn and was having difficulties with swallowing. He was diagnosed with oesophageal cancer. Due to his age (69) he was not able to have an operation to remove the tumour and therefore started aggressive chemotherapy.

My mum, already retired, became a full-time carer. Both of their worlds completely changed. Mum was fit and healthy and very independent, attending her gym and tai chi and visiting me and my brother who now live far away. As time went on, she lost everything due to Dad’s illness.

After a few months, Dad stopped being able to eat entirely and was fed through a tube. He suffered terribly with the chemotherapy and, despite three rounds, it did not shrink the tumour. Dad lived another 18 months, deteriorating during this time.

My Mum received excellent support from local health services and Dad’s Macmillan nurse. Dad tried attending the local hospice for a few afternoons but didn’t like it so Mum had no respite from him. He was both physically and psychologically demanding, as you can imagine. Marie Curie nurses were also an outstanding support to us in his last few weeks, as they took over the night shift. Because of their support, Dad was able to die at home.

Mum and Dad were typical Care & Repair clients. They had both worked all their lives and owned their own home. Dad was a mechanic and was able to maintain their large three bedroomed house until their crisis occurred. They had never received any statutory services or benefits and were therefore unaware of how to access support.

Due to where they lived in England, they did not have access to Care & Repair services like the Care & Repair services we manage here in Wales. Upon leaving hospital after falling and breaking his leg, Dad would have been eligible for our Rapid Response Adaptations Programme for adaptations to help him and Mum move him safely around the home. Care & Repair would have helped to move the bed downstairs when necessary and would have supported Mum to access Attendance Allowance to fund the extra costs of caring for Dad. They could also have provided advice about the other services which Mum could access to support her needs as a carer. All of these things, of course, were implemented for Mum and Dad, but nowhere near as quickly and as smoothly as they would have been if they had one Agency like Care & Repair to manage this practical support.

Three years on; Mum lives alone. Her health suffered during the first few years but now she is back to her independent self. She not only lost Dad but lost all of her networks due to caring for Dad, so she has had to work hard at developing her own life again. What does she find most difficult? The answer is managing a three bedroom house and a garden, alone, without a Care & Repair handyperson to trust to do small jobs around the house and without a Care & Repair service to support her through larger works.

I wrote this blog to highlight the amazing work of carers and the agencies which supported Mum to care for Dad and allow him to die at home. I also wrote it to highlight the work of Care & Repair in Wales and why it is imperative that our services are protected in order to support the ever increasing numbers of older people in Wales to live their independent lives.

Rachel Gingell
Policy Officer, Care & Repair Cymru 

Care & Repair doctoral research project

The Care & Repair Swansea University Doctoral Research project is now live! Given many of the headline messages from social policy and Welsh Government strategy relating to housing, health, social services and primary care, around a community-based social model of healthcare and public service integration, this is an exciting opportunity. Detailed work around our main activity as a frontline, home-visiting casework service will undoubtedly trace a bigger community footprint, which should be useful for policy development at a crucial stage in the debate around future-proofing public services.

Care & Repair agencies provide a unique and standard approach to the housing, environmental and living circumstances of older people. It is a blended approach, combining social care and technical housing fabric to provide a person-centred and problem-led approach. The older person receives an individually tailored, bespoke service. This has always appeared to work well. However, in a world of integrated approaches, shrinking public investment and competitive approaches, does it still work? ‘Bespoke’ is an old-fashioned and possibly hackneyed term, so are we becoming an old-fashioned service? In a fast-moving world, where the old artisan and craft skills are disappearing, will our approach end up as ‘time consuming’ and ‘over promising and under delivering’? Living under the big community tent and marshalled by statutory partners, are we a pivotal hub and close to the tent pole, or are we a cheap resource, disappearing at the edge of the camp like a flapping guy-rope?

My take on our ‘big offer’ is that we are the most modern of public sector organisations, anticipating important strategic trends and in the vanguard of change. We are defined by our partnerships and our collaborative efforts - in the best sense, ‘co-production’ in action. Seeking to build service capacity, we were a ‘social enterprise’ brand before the social entrepreneurs moved in. If you are looking to define prevention, we are responding to the real challenges older people face before they escalate into crises. If we deconstruct the pseudo-sociological concepts of ‘social model’-speak, we are a plain-talking, honest and accessible community delivery model. For the 12,000 older people we visit in their homes each year, we are a future-proofing service, keeping them ‘ahead of the curve’ rather than ‘stuck in the past’. I would say that, wouldn’t I? What do you think? This is an opportunity to say what you want as research student Joanna Wolton begins her investigations.

Neil Williams
Head of Agency Performance and Funding, Care & Repair Cymru

At this early stage, please leave a comment on the blog if you'd like any further information. 

Launch of Care & Repair Cymru’s Equality and Diversity Handbook

Tai Pawb has been working with Care & Repair Cymru to develop a practical handbook and guide to help Care & Repair Agency staff respond to the diverse needs of older people in Wales. The guide was launched at the Care & Repair Chief Officers Network meeting on 22 April.

At times, it is easy for the diversity of older people to become hidden or not recognised with older people being viewed as one homogeneous group. There is a particular risk of this happening in areas which are falsely perceived as having no or limited diversity, such as rural areas. Viewing older people as one homogeneous group or through stereotyped lenses can lead to actions which undermine services' attempts to treat individuals with dignity and respect. However, recognising the diversity of older people can help organisations to develop more holistic approaches that are sensitive to the needs of all potential service users. Having a service that recognises and removes barriers is vitally important for people who may have faced discrimination in the past.

It is the small things that can often make a big difference. For example:

• An isolated and grieving service user being able to open up to their case worker about the death of their same sex partner. 
• A service user having their communication needs met when engaging with an agency, enabling them to feel informed, empowered and listened to. 
• Using inclusive language so that people can relate to and not feel excluded from the service. 
• A home maintenance officer treating someone’s home with respect, such as wearing shoe coverings or thinking about the implications of moving items within someone’s home.

The aim was to make the guide as practical as possible. That is why, alongside the main handbook, quick reference sheets have been developed for the different job functions within agencies. Each sheet has been tailored to reflect practical tips and information most relevant for the different roles and engagement with service users which staff members will have.

The main guide and quick reference sheets provide tips in relation to age, disability, gender, gender identity, race and ethnicity, religion and belief, sexual orientation and carers on areas such as:

• Communication
• Making appointments
• Treating individuals with respect 
• Visiting or carrying out work in a person’s home
• Office visits
• Raising awareness of services

It also highlights issues that have safeguarding implications in terms of situations where staff members come across cases of domestic abuse, hate crime and elder abuse. The main guide also notes what staff should do if they face discrimination or harassment.

It is recognised that the handbook only provides general guidance and staff are advised that they will need to respond to each person’s individual needs. Each situation and each service user is very different.

Although some of the information in the guide may seem like common sense, implementing these small actions can have a huge impact on the quality of service a person receives.

A copy of the guide can be found online here.

Mair Thomas
Equality and Diversity Officer
Tai Pawb
mair@taipawb.org / 029 2053 7635

Winter is coming...

Jon Snow knew much of the perils that lurked in the coming winter. With his battle-hardened peers in the Night’s Watch, he could see from the wall, and through forays beyond, the danger that made its home in the cold and ice. But, apart from a bad case of frostbite, what did Jon Snow and those around him suffer as a result of? Well, a lack of shared ownership of the problem, poor collaboration and, as the issues intensified, a failure to use dwindling resources in a different, more efficient way.

You wouldn’t find many of us looking pensively into the distance, muttering 'winter is coming' during August. But, let’s face it, he had the right idea. We should have a joint sense of urgency, readiness and understanding of the challenges unique to this time of year.

Outside the world of  'Game of Thrones', the statistics around fuel poverty and winter deaths are sobering. In 2012, 30% of households in Wales (386,000 households) were estimated to be in fuel poverty. This is the equivalent to 54,000 more households than in 2008. Rising fuel prices have largely been counteracted by the increases in income and energy efficiency savings in the housing stock, and this has led to the increase in the number of fuel poor households.

Fuel poverty is a significant cause of excess winter deaths and, in 2012/13, there were 1,900 excess winter deaths in Wales. This was a 32% fall from the previous winter, which had seen the highest number since 1999/2000, but still above the 10 year average. 89% of these deaths involved people aged 65 or over, with the highest rate amongst those over 85 who constituted nearly 60% of the total.

There is much being done in an attempt to reduce these figures. For example, Care & Repair Cymru works with older people across Wales to support them to live in warm, safe and secure homes. This work is continued throughout the year; however, it is particularly pertinent heading toward the winter months. This year, Care & Repair agencies are offering free winter warm packs, containing a blanket and hot water bottle. These packs help to promote Care & Repair agencies as a service to help older people prepare for and manage safely through the winter.

Housing associations are doing much to offset the impact of fuel poverty, including:

• Improving the energy efficiency of homes through the Welsh Housing Quality Standard and energy programmes such as Arbed
• Helping tenants maximise their income through projects such as the Your Benefits are Changing (YBAC) campaign. YBAC helps tenants to claim benefits they are entitled to. One area of success has been the identification of the Warm Home Discount - YBAC last year successfully assisted over 914 people to claim a rebate which equates to an annual sum of £127,960. 
• Helping to try to negate energy price increases through such actions as behavioural change for energy use. 

Across public services, the impacts of winter are likely to be felt more profoundly in the Welsh NHS. Winter preparedness is a key task for Health Boards, and a hot topic within the media and public sphere. But it’s important, particularly now in the context of prudent healthcare, that we all take responsibility as individuals and organisations to meeting the winter challenge.

In terms of working with housing associations:

• Creating capacity for step down accommodation in Extra Care and Sheltered Housing
• Placing housing professionals within hospital discharge teams to decrease delayed transfer of care
• Working with housing associations to facilitate and coordinate community activity during the winter months
• Partnering to ensure that advice and information is accessible in a range of community settings and media formats. 

Of course, this should all rightly go beyond what we plan as organisations and a mix of services. Last year, Public Health England called for 100,000 people to check on neighbours over the winter months.

We should be using this time to reignite our sense of community, decrease loneliness and isolation during months when these may be felt more profoundly and together contribute to managing the demand on GP or A&E service during these months. Everyone can help, from championing local services, clearing roads, communal snowman building, committing your long term future to the Night’s Watch – it’s the small gestures that will truly make a difference this Christmas. It could put a smile on someone’s face, it could save a life.

Matthew Kennedy
Policy Officer: Care, Support and Health

The scandal of pensioner winter deaths

Why is society in Wales so prepared to put up with more older people dying in the winter compared to other months of the year?

In 2012/13, the Chief Medical Officer for Wales confirmed that this is the case with 1,900 more deaths in the winter months, with 70% of these attributed to our over 75 year olds. This pattern is repeated year on year.

Why? Because as we age, we become frailer, our bodies are less able to cope with low temperatures and we become more susceptible to respiratory and circulatory illness.

This is backed up by accepted figures in Wales that 140,000 pensioners are in fuel poverty, meaning they need to spend more than 10% of their income on fuel costs.

“Just turn the heating on”, I hear you say. It’s not as simple as that. With rising energy costs and many older people on a fixed income, many cannot afford to pay their fuel bills... so they don’t turn on the heating. Many older people face many difficult decisions, like choosing between eating or heating their home.

Many thousands of older people can’t survive on their state pension or are not claiming the benefits they are entitled to. They have boilers which are old, inefficient and use more fuel. They live in properties which aren’t insulated. They are on an expensive fuel tariff and don’t know how to change provider. They don’t know about the latest government grant scheme that just might be able to help them.

This isn’t good enough. It is clear that the system isn’t working because we still have older people dying in the winter who wouldn’t be dying in other months of the year.

While there are undoubtedly plenty of schemes that could help, there is confusion for older people about where to go and what help they can get, and we are not doing enough to find and help the people who need that help the most.

There have been numerous grant schemes, over many years, such as Home Energy Efficiency Scheme (HEES), Carbon Emissions Reduction Target (CERT), Community Energy Saving Programme (CESP), and now, the NEST and Energy Company Obligation (ECO). There is lots of evidence to suggest that these schemes have helped improve many properties, helped many people on low incomes and reduced carbon emissions, particularly in the social housing sector. Housing associations and local authorities have undoubtedly carried out some great work with energy companies for the benefit of their properties and their tenants.

We now need to focus on the people we haven’t reached. One particularly affected group is low income, older owner occupiers dispersed in urban, suburban and rural areas across all of Wales. Finding these people requires more up front effort and is not as attractive to energy companies who have legal targets on the quantity of carbon emissions they need to reduce, so instead have targeted geographic energy efficiency schemes at scale.

So, to combat older people dying of cold this winter, Care & Repair Cymru is running their Fighting Fuel Poverty campaign this week (October 20-24) to find older people who are most at risk and to provide them with practical advice.

We aim to help them access benefits and available grants to keep them warm, as well as assisting them directly with our “Health through Warmth” grants, delivered in partnership with Npower.

We’re also asking people who receive the winter fuel payment, but don’t need it, to donate it to a hardship fund at Care & Repair by calling 0300 111 3333 so that we can redirect this to older people in fuel poverty who need more help.

As we head into the winter months and look ahead to the UK elections next year, we believe that the UK and Welsh Governments need a rebalancing of policy focus so that tackling fuel poverty and stopping winter deaths amongst our older people receives as much attention as reducing CO2 emissions.

We need co-ordinated action by government and energy companies to target advice and energy efficiency grants based on specific need of individuals as well as wider need to reduce the carbon footprint.

As the Older People’s Housing Champion for Wales, our “Fighting Fuel Poverty” campaign aims to highlight the scandal of pensioner winter deaths and find solutions to help those in need. We’re only a phone call away, so if you’re an older person or have a relative, neighbour or friend in need of help, please call one of our local agencies on 0300 111 3333. Care & Repair can reach out and spread a bit of human kindness and warmth this winter to those feeling left out in the cold.


Chris Jones
Chief Executive
Care & Repair Cymru

Working in partnership for warmer homes

With Autumn now firmly taking hold, people across the country are starting to turn the heating on. However, it’s easy to forget that not everyone has the luxury of keeping their home warm.

A warm home has a significant impact on our health and wellbeing. As research has shown, cold temperatures can have a detrimental effect on people with long-term health conditions such as heart, circulatory and respiratory disorders, as well as the elderly community.

Indeed, this subject has become a real focus for the Government in recent months, with calls for a collaborative approach across the health sector to ensure that those who need it most are able to heat their homes. Recent guidance from the National Institute for Health and Care Excellence (NICE) has also added to the debate, calling for the wider community, from gas engineers to health workers, to work together to identify vulnerable people who are at risk.

This partnership approach is one that npower Health Through Warmth has championed since the scheme began in 2000, by working with organisations such as Care & Repair Cymru. Together, we help vulnerable people to stay warm at home, whether it’s by replacing broken boilers or installing heating systems or loft and cavity wall insulation.

That’s why npower Health Through Warmth is supporting Care & Repair Cymru's Fighting Fuel Poverty campaign, to remind people that help may be available for vulnerable home owners who have a long term illness, a low income with little or no savings and who are unable to fully fund the work required.

For more information, or to find out if you or someone you know could be eligible for help, visit www.healththroughwarmth.com or contact your local Care & Repair Agency on 0300 111 3333.


Elaine Midwinter
Scheme Manager
npower Health Through Warmth

Fighting fuel poverty - let Care & Repair help you

According to latest figures, there are almost 2,000 excess winter deaths a year in Wales. We hear the term ‘excess winter deaths’ quite frequently, but it’s hard to imagine how and why this can happen.

As an Affordable Warmth Caseworker for Care & Repair Cardiff, visiting older people on a daily basis in their homes, unfortunately I can see how this happens. When reporting on this issue, the press might conjure up images of older people with blankets around their knees, shivering in front of a gas fire. This is not the case for the majority of older people, but for some this is actually their reality.

I saw a lady recently in Riverside who was wearing a dressing gown over her clothes to keep warm every time I visited her. I saw a gentleman in Canton who wore a woolly hat and refused to put the heating on unless it snowed because he was scared of high gas bills. I saw a lady in Grangetown who had no form of heating whatsoever in the house, had never had any, and cried every time I visited as she couldn’t face another winter living that way. Unfortunately, this is how some older people live, and it is easy to see how their health and wellbeing can be affected.

Many older people live on low incomes, have little or no savings and live in homes that don’t suit their needs. Quite often, they live in the family home that they have lived in for decades which they now find that they can’t afford to maintain or heat adequately. There are often problems with the heating system, windows and damp, along with stairs and bathrooms that can’t be managed. Many people are just used to managing and used to be being cold; they’re not aware of the damage it could be doing to their health or where to go for help. Poor physical health and mental health problems can also complicate the issue and make it difficult for people to find and access help, or even to face having anything done to their home.

There is help out there. We can help people to find grants to improve their home and heating and support them through the process of having any work done. We can help people to take control of their bills by looking at changing supplier or making sure they are on the best tariff. We also make sure that people are claiming all the benefits they are entitled to which can vastly increase their income and make life a little easier. We’ve also helped people to clear gas and electricity debts.

I think it will be difficult to find a long term solution to fuel poverty. Grants for new boilers are excellent in the short term, but what happens in 10 years time when that boiler is inefficient again? It’s not a long term solution to the problem. We hear that insulating our homes is the best solution, but most people have had cavity wall and loft insulation fitted and accessing more complicated specialist measures is difficult and very expensive.

One thing I have come to learn in this job is the importance of planning for your old age. Older people should be able to live out their later years in comfort without worrying about living in cold homes which don’t suit their needs. It’s of benefit to everyone of any age to think about maintaining their homes, having appliances regularly serviced and using energy as efficiently as possible. These are all things that Care & Repair can assist with, so I would advise anyone who needs advice to contact us on 0300 111 3333.


Beatrice Roberts
Caseworker, Care & Repair in Cardiff

Fighting Fuel Poverty

The impact of fuel poverty goes beyond financial consequences. Living in fuel poverty can affect people’s health, increasing the risk of common ailments such as colds, flu and respiratory infections including bronchitis. This has resulted in worryingly high excess winter death levels in Wales, with older people particularly susceptible.

There are indirect effects: stress in children and adults, long-term depression and anxiety, social exclusion, damaged health and life chances for families and individuals and reduced educational attainment.

Moreover, there are broader budget implications for education, employment and health services in Wales.

You are in fuel poverty if 10% or more of your household income is spent on energy.

The causes of fuel poverty are equally complex, requiring a person centred approach alongside energy efficiency measures.

In 2012, 30% of households in Wales were living in fuel poverty, equating to 386,000 homes. Nearly 85% of these are vulnerable households, containing a child, older person or someone with a disability or chronic illness.

Energy efficiency is not the only way of helping fuel poor households and further opportunities exist, including helping people to find the best energy deal and to maximise their income.

True partnership working is key to finding those who are hardest to reach, ensuring that they receive all the help they are entitled to and developing solutions to meet their needs and situation.

No one agency can provide all the solutions to a complex problem affecting people with diverse circumstances. However, a central movement such as Care & Repair Cymru can guide people in the right direction to obtain the help they need.

Last year, Care & Repair agencies gave energy advice to 1,800 older people and 1,000 older people who had damp in their home. Amongst other things, they can advise on whether you are eligible for a £140 Warm Home Discount on your electricity bill and how, as a pensioner, you can join your energy supplier’s Priority Services Register.

If you require help or are unsure about the help you can receive, then contact Care & Repair for free advice on 0300 111 3333.

Mark Isherwood AM 

Chair of the Cross Party Group on Fuel Poverty sponsored by NEA Cymru and Citizens Advice Cymru 

Positive ageing - bucking the trend?

This week is Positive Ageing Week, which also includes Older People’s Day today, (1 October). The narrative around ageing and particularly around the substantial increase in the number of older people in the coming decades is often focused on the challenges of increasing demand for services and the fact that, across public services, we aren’t ready to accommodate this need.

At Care & Repair’s recent Annual Conference, a consultant from Powys Teaching Health Board (Prof. Bim Bhowmick) spoke about caring for older people with more acute needs in the community. One of his main points, which really resonated with me, was in saying that an increase in the older population doesn’t have to mean greater demand… more need… pressure on hospital services. He’d been leading on a consultant led “virtual ward” service aimed at keeping older people out of hospital. Through this he demonstrated a few things, namely:

• Consultant-led community services for older people will reduce attendance at A&E and instances of delayed transfer of care.
• Services configured to intervene at the time, before someone is admitted to hospital for further checks etc., is by far the most important time to intervene. 
• Ensuring that there's an understanding of what can be provided in the community by NHS staff and other stakeholders is key for General Practitioners. 
• The home is often an appropriate place to provide interventions for people with acute needs. 
• If we make these changes on an all-Wales level, we can realise a future where even though there’s a large population of older people, better service focus along with changes in lifestyle and behaviour can combine to offset the type of demand being predicted at present. 

The way we understand housing in the context of positive ageing is also very important. All too often this is a bit one dimensional – along the lines of poor housing leads to poor health. Clearly this is a really important part of understanding the impact housing can have, and the implications of poor housing. But an over-focus on the physical environment may lead us to overlook much of what it means to age positively. Housing certainly underpins this, but (for example) opportunities to socialise, learn new skills, inform and participate in local and national debate, spend more time with family, work or volunteer and travel the world can all have a huge bearing on how 'positively' we age. 

For the housing sector, it’s about understanding how we can best support this shift in emphasis and if there’s capacity to provide staff, share expertise or facilitate patient, carer or family engagement in building a shared understanding of how we support people in truly holistic way. 

Matthew Kennedy
Policy Officer: Care, Support and Health

Cardiff's Healthy @ Home Service - doing the right thing at the right time

Housing and health are closely linked and health related work has become a key part of what we in Care & Repair do, both to improve people’s overall health and to make them safer in their home by preventing accidents and potential hospital admission. Because we visit older people in their own homes, we have the ideal opportunity to discuss a range of healthy issues as well as their housing needs.

The Healthy @ Home Casework service is a partnership project, funded by the Welsh Government’s Intermediate Care Fund, which works with GP surgeries across Cardiff to offer the Care & Repair service to their patients on their 75th birthday. During the home visit to the client, we can offer a range of services that may be of interest to them now or in the future. Our aim is to support the client to stay safely living at home for longer, thus having a long term positive impact on their health and wellbeing.

We all know the saying: prevention is better than cure. Our service gives us access to older people who may benefit from our services and those of other organisations at an early stage to support them living independently and to prevent them from reaching a crisis situation in their home.

As well as discussing home repairs, maintenance and adaptations, we provide assistance with welfare benefits, home safety and fire safety checks and information on health and well being. If relevant, people are assessed for falls and referred back to their GP for a follow up appointment. Our project is unique in Cardiff and of real benefit and help to older people.

During our home visit, the Healthy @ Home Caseworker will listen to what the client wants and needs, will make suggestions and offer solutions to address these issues. By addressing the needs of clients, we undertake and organise a variety of direct interventions or make referrals to existing voluntary and statutory agencies to draw in and co-ordinate with other services as appropriate. Through partnership working with other voluntary and statutory agencies, we can provide the right assistance at the right time.

There is so much information available, much of which is, or seen by our clients as, complex. Many clients are not accessing schemes due to a misunderstanding of the referral process.

It is our experience that our clients still prefer a home visit where someone speaks to them face to face, someone who is willing to understand and discuss their needs. That someone is a Care & Repair Healthy @ Home caseworker.

Julie Swain
Senior Caseworker, Care & Repair Cardiff

Who says health, housing and social care can't work together?

I heard about The King's Fund ‘Innovations in the delivery of care for older people’ conference through Twitter. The King's Fund wanted to showcase different innovative projects at the event and were inviting submissions. I immediately thought of the Rapid Response Adaptations Programme (RRAP). While it's not a traditional ‘care’ project, it is an excellent example of a successful partnership between housing, health and social care sectors, which are usually more 'fragmented'.

The majority of referrals to the RRAP programme are received through social care and health practitioners such as occupational therapists, social workers, physiotherapists and discharge nurses, who are happy to place their trust in our voluntary sector organisation to support their work. It is a real achievement that each Care & Repair agency, across all of the 22 local authority areas in Wales, has been able to develop such positive relationships with their health and social care teams.

The Rapid Response Adaptations Programme is funded by the Welsh Government and allows Care & Repair agencies to carry out minor adaptations, such as ramps and handrails, to enable people to return safely to their own homes following hospital discharge. These adaptations can also prevent the need for admission to hospital or residential care. The programme requires these adaptations to be completed within 15 working days, although jobs can be carried out immediately in response to a crisis.

For health professionals, not only are ‘hospital beds unblocked’, allowing clinical scheduling and prioritisation to improve, there are clear indications of cost savings through the programme. It has been estimated that £7.50 is saved in Health and Social Care costs for every £1 of public funding invested in RRAP.

A recent report found that, by 2017, demand for unpaid care will begin to exceed supply, and the ‘care gap’ will grow sharply from then onwards. In turn, pressures on A&E departments and hospitals are likely to increase, as fewer older people receive the care they need and more are likely to slip into crisis (IPPR 2014).

Care & Repair Cymru carried out a survey of stakeholders in 2011. One hundred per cent of respondents felt that RRAP had helped to delay or prevent the need for social care services.


Stakeholders told us:

• RRAP promotes independence in the home and therefore reduces long term dependency on care. 'People are able to remain in their own homes for longer and it reduces the demand for more costly support from social services.'

• 'There is benefit (from RRAP) to the quality of service users’ lives which is greatly overlooked but of great significance.'


It is recognised that most people, as they grow older, would like to remain living in their own homes (Wanless, 2006). The demand for services such as RRAP which contribute to enabling older people to remain living independently in their own homes is likely to increase as the ageing demographic increases. The programme has proved to be extremely cost effective and yet the service remains unique to Wales.

The benefits of the RRAP programme were recognised by The King's Fund panel and were presented to the audience at the conference on 18 June.

Whilst attending the conference, it was clear that most of the innovations showcased, all immensely exciting and inspiring, were mostly carried out within the confines of one local health area. Care & Repair, however, supported by Welsh Government funding, work across the whole of Wales, ensuring equity of service for older homeowners and not confined by boundaries. Hopefully, by sharing good practice through such events, older people across the UK will gain greater access to excellent services such as those showcased at the conference.

NB. In the previous year, Care & Repair agencies carried out almost 15,500 works through the Rapid Response Adaptations Programme.


Rachel Gingell, Policy and Research Officer
Care & Repair Cymru 

Reducing the risk of falling

As we grow older, gradual changes to our health and the medications we take can contribute to an increased risk of falling.

Every year, around one in three over-65s living in the community and one in two people aged over 85 will have a fall.

There are many reasons why the risk of falls and fractures increases with age, including weaker bones and muscles and being less mobile. However, many falls can be prevented and are often due to hazards that are easy to overlook but equally easy to fix.

Falls Awareness Week 2014 is about helping to reduce the risk of falls among older people by identifying some of those fixes.

There are many simple changes you can make around your home to reduce the risk of falls – indoors and out.

Checking for hazards which can cause a slip, trip or fall on floors, steps and stairs in the bathroom, bedroom, kitchen and garden can help you to reduce the risk of falling.

It is also important to look at and address the fear of falling that some people may have. This anxiety may stem from having already had a fall and can lead to older people losing confidence and becoming isolated and depressed.

We also need to consider the role that medication can play in falls. Some medications including sedatives or strong painkillers can cause drowsiness, while others may alter your vision, hearing or concentration.

If you are worried about falls, Age Cymru has produced a guide called ‘Avoiding slips, trips and falls’. It gives tips on how to reduce the risk of falling at home and includes a self-assessment form about your general wellbeing.

‘Avoiding slips, trips and falls’ is available for free from Age Cymru’s Healthy Ageing Team by contacting them on 029 2043 1555, or emailing ageingwell@agecymru.org.uk. You can also download it from the Age Cymru website – www.agecymru.org.uk.


Rosalyn Williams
Health Initiatives Officer, Age Cymru

Older People's Commissioner for Wales: An update

Earlier this year, I released a report calling for the preservation of community services which are essential for helping older people to maintain their health, independence and wellbeing.

The report, entitled ‘The Importance and Impact of Community Services within Wales’, outlines the importance of provisions including buses and community transport, public toilets, pavements, public seating, outdoor areas, libraries, leisure facilities, community and day centres.

There is real concern among many older people that these vital services are disappearing, which will have a devastating impact on their lives.

The evidence in the report was drawn from a series of focus groups that took place with older people around Wales, as well as from a range of partners with expertise in specialist areas.

Many of these older people are housing association tenants and I meet them at home, in their residential complexes and schemes, as well as at the various clubs and groups which they are members of, through my ongoing Engagement Roadshow.

The community services that older people consistently talk about are not luxuries, but are lifelines to helping them stay independent, healthy and connected to their local communities, their friends and families.

I understand the current budgetary pressures being placed upon Local Authorities and that difficult decisions on expenditure and savings must be made. It is vital, however, that as spending decisions are made, essential community services are recognised as being as impactful and as important as statutory services and that older people are able to continue to access them.

Building on the report, I will publish a toolkit later this year to help housing association residents and all older people to engage with Local Authorities and influence the decisions that affect them.

I am also planning a number of seminars for key local authority staff, to present the case for the retention of community services, facilities and infrastructure in Wales and to discuss and agree an effective way forward.

For a copy of ‘The Importance and Impact of Community Services within Wales’ or to find out more about my work across the country, visit www.olderpeoplewales.com or call 08442 640670.

Sarah Rochira
Older People's Commissioner for Wales

Warmer homes, better health

We may not want to admit it, but as we get older we face an increased risk of health problems. But how many of us recognise how important a warm home is to our health and wellbeing?

Indeed, research has shown that cold temperatures can increase your heart rate, blood pressure and risk of chest infections. Keeping the most used rooms in your home warm could help to prevent your health being adversely affected by the cold. The recommended temperatures are 21°C for the living room and 18°C for the bedroom, but can be higher depending on personal preference, your age and level of mobility.

At npower Health Through Warmth, we work closely with Care & Repair Cymru to help vulnerable older people stay warm at home by, for example, replacing broken boilers or installing heating systems and loft and cavity wall insulation.

That’s why we’re supporting Care and Repair Week and reminding people, both clients and caseworkers, that help from npower Health Through Warmth may be available to vulnerable homeowners who have a long term cold-related illness, a low income with little or no savings and who are unable to fully fund the work required. You do not have to be, or become, an npower customer to benefit from the scheme.

To date, through our work with Care & Repair Cymru, more than 200 older people in Wales have been referred to us for help with heating and insulation. As a result we have levered more than £150,000 to help fund the work required, which includes £130,000 from the unique npower Health Through Warmth Crisis Fund.

For more information, or to find out if you or someone you know could be eligible for help, contact your local Care & Repair Agency on 0300 111 3333.


Elaine Midwinter
Scheme Manager
npower Health Through Warmth
www.healththroughwarmth.com

Helping clients to surf the information superhighway

The aim of Care & Repair is to enable clients to remain safely and independently in their own homes. Part of the service we offer is for caseworkers to visit clients at home - many of whom are socially isolated, live in rural areas or where there is limited public transport. Some find it difficult to get out and about and rely on family and friends for support, and other clients’ families and friends live too far away to be able to offer the support needed. However, many of the things our clients find harder to do can all be done online - shopping, chatting to family and friends, sending and receiving photos.

Not everyone wants to be online! However, often people are unaware of the benefits or just need extra support to get online. Sometimes the cost of getting online can also be a major barrier.

It is important that we as caseworkers help clients to understand how the internet can be relevant in their everyday lives. One way we do this is by explaining how convenient the internet is. Like all my colleagues across Wales, I use an iPad for work as part of the Care & Repair myPad project. This means I can show clients the benefits of using digital technology and explain the importance of being ‘digitally included’. Once clients see how easy the tablets are to use, it breaks down one of the biggest barriers – the fear of using IT.

I explain how money can be saved by shopping online, as many items are cheaper and price comparison websites can help find the best deals. Some of my clients now order their prescriptions online, have shopping delivered, and speak with family and friends. Some have contact with their social and church groups (through Skype and face time), and use social networking sites to keep in touch and to learn new skills. One client is doing a degree course online, others download reading and audio books, some do their banking online and many enjoy games and puzzles.

The majority of these new skills also improve the client’s self-esteem, confidence and wellbeing, and ultimately help to reduce a feeling of social isolation.


Beverley Evans
Caseworker, Blaenau Gwent Care & Repair 


Watch our video for Care & Repair Week here. Helping nannies and grampies all over Wales!

Only the lonely...

On a wild windy day, only 50m from the crashing waves of Cardigan Bay, Sarah Rochira (Older People’s Commissioner) and her colleague Kelly came to visit Mrs Jones in Aberystwyth, whose terraced house nestles snugly against the castle walls.

We have been helping Mrs Jones to reduce her eye-watering £318 per month Direct Debit from Scottish Power. Mrs Jones had reached the end of her tether in trying to contact Scottish Power since August, when her payments went up to this incredible figure. We hit the same impenetrable brick wall, and only found a way through by using the Welsh language service. Having given the helpful Scottish Power officer the updated meter readings, we have reduced her Direct Debit to a still painful £192 per month. We are working with the client to tackle her inefficient heating scheme.

The Commissioner’s conversation with Mrs Jones, however, uncovered a wider and far more personal issue, common to far too many older people, even in close knit urban areas. Loneliness and isolation was her real heartache. 'I've always been such a sociable person, I loved going out... I've only been out of the house once in the past year, and that was only up the road to St Michael's Church for a funeral.'

The house is accessed via numerous steep, uneven, and varying height steps and, whilst a handrail has been fitted, Mrs Jones still sees the climb back up as an Everest too daunting to face.

Why doesn't she find a more suitable property? A flat or a sheltered scheme?

Herein lies the problem. This is not Mrs Jones's house, it is her home! Her home, which was bought nearly 50 years ago when she was newly married. 'We put in an offer on it and were worried sick all night, but it was the best thing we ever did.... We’ve raised our children and grandchildren here and my grandson still lives with me. I do not want to leave my home.'

The third sector, including us at Care & Repair, must continue to work together to help older people in all aspects that affect their ability to remain independent. That means far more than repairs and adaptations alone, it's all about the 'Care'.

Lesson relearned!


Dafydd Pugh-Jones
Rheolwr Gofal a Thrwsio / Care & Repair Manager